Establishing the Effect of Vibration and Postural Constraint Loading on the Progression of Intervertebral Disc Herniation
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Intervertebral disc herniations have been indicated as a possible injury development pathway due to occupational vibration exposures in seated postures through epidemiological investigations. Little experimental evidence exists to corroborate the strong epidemiological link between intervertebral disc herniations and vibration exposures using basic scientific approaches. The purpose of the current investigation was to provide some basic experimental evidence of the epidemiological link between intervertebral herniation and exposure to vibration. Partial intervertebral disc herniations were created in in-vitro porcine functional spinal units using a herniation protocol of repetitive flexion/extension motions under modest compressive forces. After herniation initiation, functional spinal units were exposed to 8 different vibration and postural constraint loading protocols consisting of two postural conditions (full flexion and neutral) and 4 vibration loading conditions (whole-body vibration, shock loading, static compressive loads, and whole-body vibration in addition to shock loading) to assess the effects of vibration and posture on functional spinal unit damage progression. There were three main outcome variables used to quantify damage progression; average stiffness changes, herniation distance progression (distance of tracking changes), and specimen height changes, while cumulative loading factors were considered. Additionally the concordance between two types of contrast enhanced medical imaging (Computed Tomography and discograms) was qualified to a dissection ‘gold standard’, and an attempt was made to classify disc damage progression via three categorical variables. Concordance to a dissection ‘gold standard’ was higher for the Computed Tomography medical imaging type that for the Discograms. The categorical criteria used to qualify disc damage progression were insufficiently sensitive to detect damage progressions illustrated through dissection and medical imaging techniques. The partial herniation loading protocol was quantified to be more damaging overall to the functional spinal units compared to the vibration and postural constraint loading protocols. However, the vibration and postural constraint loading protocols provided sufficient mechanical insult to the functional spinal units to progress damage to the intervertebral discs. Vibration loading exposures were found to alter specimen height changes and distance of tracking changes, however posture had no significant effects on these variables. Neither posture nor vibration loading had any meaningful significant effects on average stiffness changes.